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General NPI Number Information
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NPI Number | 1164410205
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Entity Type | Individual
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Provider Name | DANIEL W. LOVELL R.PH.
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Gender | Male
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Dates
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Enumeration Date | 10/12/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4900 SAINT JOE RD
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City | FORT WAYNE
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State | IN
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Zip | 46835-3275
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Country | US
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Telephone | 260-969-1794
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Fax | 260-969-3879
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Provider Business Mailing Address
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Address Line | 6812 COVINGTON CREEK TRL
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City | FORT WAYNE
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State | IN
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Zip | 46804-2872
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Country | US
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Telephone | 260-434-1280
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26020296
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | C-4968
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License Number State | TN
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